CNS — Federal officials have praised Maryland for leading national efforts to implement health care reform, but critics caution against spending limited funds on a law in jeopardy of repeal.

Since 2007, the state has expanded health coverage to more than 289,000 Marylanders. Today, Maryland is recognized as one of the first to embrace the federal Affordable Care Act passed in 2010 and to begin implementing its provisions.

“You really are a leader in what you’re accomplishing both in terms of health care reform and the Affordable Care Act,” Joanne Grossi, regional director of the U.S. Department of Health and Human Services, told a group of Maryland officials.

But some policy experts are concerned that Maryland’s commitment to health reform could prove shortsighted if the law, expected to be reviewed by the Supreme Court, is overturned.

Michael Cannon, director of health policy studies at the Cato Institute, strongly opposes the national health care law. He is one of the critics who argue that creating government bureaucracies like the Maryland Health Benefit Exchange, designed to enforce federal health care regulations and dole out funding, is a waste of money if the law is overturned.

“They should not be spending money they don’t have to implement a law that could be wiped from the books,” Cannon said. “They’re being rash.”

“A lot of states are taking the more prudent path of wait-and-see what the courts will rule,” Kilmer said. “Maryland is betting that the Affordable Care Act is going to be in place over the next decade, and that the funding is going to be in place.”

Lt. Gov. Anthony Brown stands by the state’s actions, including the formation of the health benefit exchange.

“National health reform gives us the tools to continue doing what we’ve been doing in Maryland for years,” Brown said. “Regardless of what actions the federal government is going to make, we’re going to do everything we can to provide access to health care to as many Marylanders as possible.”

The state’s Health Care Reform Coordinating Council, designed to ensure collaboration among the government entities that are responsible for implementing provisions of the law, met recently to discuss Maryland’s progress.

Two Maryland residents who have benefited from recent changes in health policy, Fred Miller and Jamie Engels, spoke during a September meeting.

Miller, who at 65 endured a triple bypass, lost his life savings, and faced bankruptcy, said he couldn’t afford the prescription drugs he needed to survive.

“There I was, with a drained bank account, living off Social Security — it just wasn’t enough,” Miller said. “Without some help from somewhere, I probably wouldn’t be here now.”

Miller was able to afford his prescription medications thanks to provisions of the Affordable Care Act that helped extend the Maryland Senior Prescription Drug Assistance Program.

Engels, 29, had been living without health insurance for nearly nine months after unexpected unemployment left her without coverage and a previous kidney issue made her ineligible for a new plan. She became qualified for the Maryland Health Insurance Plan (MHIP) under a new federal high-risk pool program, which expanded coverage to many uninsured Marylanders.

“It changed my life,” Engels said, referring to the reform that enabled her to become insured. “I was able to go to the doctor. I don’t know where I’d be if it wasn’t for that.”

Programs like the high-risk pool are only meant to provide coverage until 2014, when — according to the law — all Americans will have access to affordable health insurance. But that may not be the case should the individual mandate — which requires all Americans to obtain health insurance — be found unconstitutional and repealed by the Supreme Court.

This uncertainty has many questioning the gusto with which Maryland has embraced the law.

“I don’t think we are moving too quickly,” Quattrocki said, in response to those who believe Maryland should take a ‘wait-and-see’ approach. “We have a responsibility to Maryland that we will be up and ready to go in 2014.”